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Community-acquired Invasive Bacterial Disease in Urban Gambia, 2005–2015: A Hospital-based Surveillance
Background. Invasive bacterial diseases cause significant disease and death in sub-Saharan Africa. Several are vaccine preventable, although the impact of new vaccines and vaccine policies on disease patterns in these communities is poorly understood owing to limited surveillance data. Methods. We c...
Autores principales: | , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6761311/ https://www.ncbi.nlm.nih.gov/pubmed/31505627 http://dx.doi.org/10.1093/cid/ciz463 |
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author | Darboe, Saffiatou Okomo, Uduak Muhammad, Abdul-Khalie Ceesay, Buntung Jallow, Mamadou Usuf, Effua Tweed, Sam Akpalu, Edem Kwambana-Adams, Brenda Kariuki, Samuel Antonio, Martin Bradbury, Richard S Forrest, Karen de Silva, Thushan I Lawal, Bolarinde Joseph Nwakanma, Davis Secka, Ousman Roca, Anna |
author_facet | Darboe, Saffiatou Okomo, Uduak Muhammad, Abdul-Khalie Ceesay, Buntung Jallow, Mamadou Usuf, Effua Tweed, Sam Akpalu, Edem Kwambana-Adams, Brenda Kariuki, Samuel Antonio, Martin Bradbury, Richard S Forrest, Karen de Silva, Thushan I Lawal, Bolarinde Joseph Nwakanma, Davis Secka, Ousman Roca, Anna |
author_sort | Darboe, Saffiatou |
collection | PubMed |
description | Background. Invasive bacterial diseases cause significant disease and death in sub-Saharan Africa. Several are vaccine preventable, although the impact of new vaccines and vaccine policies on disease patterns in these communities is poorly understood owing to limited surveillance data. Methods. We conducted a hospital-based surveillance of invasive bacterial diseases in The Gambia where blood and cerebrospinal fluid (CSF) samples of hospitalized participants were processed. Three surveillance periods were defined in relation to the introduction of pneumococcal conjugate vaccines (PCVs), before (2005- 2009), during (2010–2011) and after (2012–2015) PCV introduction. We determined the prevalences of commonly isolated bacteria and compared them between the different surveillance periods. Results. A total of 14 715 blood and 1103 CSF samples were collected over 11 years; overall, 1045 clinically significant organisms were isolated from 957 patients (972 organisms [6.6%] from blood and 73 [6.6%] from CSF). The most common blood culture isolates were Streptococcus pneumoniae (24.9%), Staphylococcus aureus (22.0%), Escherichia coli (10.9%), and nontyphoidal Salmonella (10.0%). Between the pre-PCV and post-PCV eras, the prevalence of S. pneumoniae bacteremia dropped across all age groups (from 32.4% to 16.5%; odds ratio, 0.41; 95% confidence interval, .29–.58) while S. aureus increased in prevalence, becoming the most prevalent bacteria (from 16.9% to 27.2%; 1.75; 1.26–2.44). Overall, S. pneumoniae (53.4%), Neisseria meningitidis (13.7%), and Haemophilus influenzae (12.3%) were the predominant isolates from CSF. Antimicrobial resistance to common antibiotics was low. Conclusions. Our findings demonstrate that surveillance data on the predominant pathogens associated with invasive disease is necessary to inform vaccine priorities and appropriate management of patients. |
format | Online Article Text |
id | pubmed-6761311 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-67613112019-10-02 Community-acquired Invasive Bacterial Disease in Urban Gambia, 2005–2015: A Hospital-based Surveillance Darboe, Saffiatou Okomo, Uduak Muhammad, Abdul-Khalie Ceesay, Buntung Jallow, Mamadou Usuf, Effua Tweed, Sam Akpalu, Edem Kwambana-Adams, Brenda Kariuki, Samuel Antonio, Martin Bradbury, Richard S Forrest, Karen de Silva, Thushan I Lawal, Bolarinde Joseph Nwakanma, Davis Secka, Ousman Roca, Anna Clin Infect Dis Supplement Articles Background. Invasive bacterial diseases cause significant disease and death in sub-Saharan Africa. Several are vaccine preventable, although the impact of new vaccines and vaccine policies on disease patterns in these communities is poorly understood owing to limited surveillance data. Methods. We conducted a hospital-based surveillance of invasive bacterial diseases in The Gambia where blood and cerebrospinal fluid (CSF) samples of hospitalized participants were processed. Three surveillance periods were defined in relation to the introduction of pneumococcal conjugate vaccines (PCVs), before (2005- 2009), during (2010–2011) and after (2012–2015) PCV introduction. We determined the prevalences of commonly isolated bacteria and compared them between the different surveillance periods. Results. A total of 14 715 blood and 1103 CSF samples were collected over 11 years; overall, 1045 clinically significant organisms were isolated from 957 patients (972 organisms [6.6%] from blood and 73 [6.6%] from CSF). The most common blood culture isolates were Streptococcus pneumoniae (24.9%), Staphylococcus aureus (22.0%), Escherichia coli (10.9%), and nontyphoidal Salmonella (10.0%). Between the pre-PCV and post-PCV eras, the prevalence of S. pneumoniae bacteremia dropped across all age groups (from 32.4% to 16.5%; odds ratio, 0.41; 95% confidence interval, .29–.58) while S. aureus increased in prevalence, becoming the most prevalent bacteria (from 16.9% to 27.2%; 1.75; 1.26–2.44). Overall, S. pneumoniae (53.4%), Neisseria meningitidis (13.7%), and Haemophilus influenzae (12.3%) were the predominant isolates from CSF. Antimicrobial resistance to common antibiotics was low. Conclusions. Our findings demonstrate that surveillance data on the predominant pathogens associated with invasive disease is necessary to inform vaccine priorities and appropriate management of patients. Oxford University Press 2019-09-15 2019-08-30 /pmc/articles/PMC6761311/ /pubmed/31505627 http://dx.doi.org/10.1093/cid/ciz463 Text en © The Author(s) 2019. Published by Oxford University Press for the Infectious Diseases Society of America. http://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Supplement Articles Darboe, Saffiatou Okomo, Uduak Muhammad, Abdul-Khalie Ceesay, Buntung Jallow, Mamadou Usuf, Effua Tweed, Sam Akpalu, Edem Kwambana-Adams, Brenda Kariuki, Samuel Antonio, Martin Bradbury, Richard S Forrest, Karen de Silva, Thushan I Lawal, Bolarinde Joseph Nwakanma, Davis Secka, Ousman Roca, Anna Community-acquired Invasive Bacterial Disease in Urban Gambia, 2005–2015: A Hospital-based Surveillance |
title | Community-acquired Invasive Bacterial Disease in Urban Gambia, 2005–2015: A Hospital-based Surveillance |
title_full | Community-acquired Invasive Bacterial Disease in Urban Gambia, 2005–2015: A Hospital-based Surveillance |
title_fullStr | Community-acquired Invasive Bacterial Disease in Urban Gambia, 2005–2015: A Hospital-based Surveillance |
title_full_unstemmed | Community-acquired Invasive Bacterial Disease in Urban Gambia, 2005–2015: A Hospital-based Surveillance |
title_short | Community-acquired Invasive Bacterial Disease in Urban Gambia, 2005–2015: A Hospital-based Surveillance |
title_sort | community-acquired invasive bacterial disease in urban gambia, 2005–2015: a hospital-based surveillance |
topic | Supplement Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6761311/ https://www.ncbi.nlm.nih.gov/pubmed/31505627 http://dx.doi.org/10.1093/cid/ciz463 |
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